This document discusses factors that can affect hair follicle implantation success, including harvesting and placement methods. Strip harvesting removes a strip of scalp tissue along with hair follicles, while FUE removes follicles directly which makes them more prone to damage from time out of body and difficult placement. Proper graft handling, sizing, orientation, and placement techniques aim to avoid issues like dehydration, trauma, and unnatural growth. Perpendicular incisions may improve results but also risk more vascular damage, while parallel incisions are easier but can damage surrounding hair. Implanters can place grafts simultaneously with incision but require skill to avoid issues compared to traditional methods. Overall, gentle, careful techniques and minimizing graft stress are emphasized

1. implantation

3. Survival
protection
naturalness

5. Potential risks
• size
• transection
• injury
• dehydration
• time out of body
• temperature
• solution
• dehydration
• density
• depth
• orientation
• size
• transection
• injury
• dehydration
• placing

6. respond to
• Does the harvesting method have any affect on implantation?
• Are there any differences between FUE and strip harvesting grafts?

7. Hair follicle

8. FUE grafts
• removed directly from the donor
• time out of body
• less soft tissue surrounding the follicles
• splayed follicles
• bulbs of different length
more difficult to place
more prone to injury and desiccation

9. •holding conditions
•graft grasping techniques
•time out of body

10. graft placement techniques
•premade incisions
•stick and place
•implanter

11. Recipient site
• vary in
• size
• shape
• depth
• width
• direction
• angulation
• orientation
• techniques
• sagittal to coronal incisions
• chisel blades to needles

12. Incision Orientation
perpendicular
• perpendicular to the long axis of hairs
• control of hair angle and direction
• improved hairlines
• greater densities
• better coverage
• vascular damage ?
• faster healing
• greater scalp coverage
parallel
• parallel to the long axis of hairs
• easier to place
• damage less of the surrounding hair
• easier to get inbetween native hairs

13. Basic Principles For Graft Placement
• maximize visualization
• avoid dehydration
• proper graft sizing
• gentle grasping
• maintaining appropriate rotation
of the natural CURVATURE
• avoid multiple placing attempts
• angle and directions of grafted
hair should match the RESIDUAl
hair

14. grasping the graft
• Ideally at the fat
• What about FUE ?
• special attention
• difficult to grasp in a bundle
formation

17. Graft Insertion into Pre-made Incisions
• Body/hand position

18. Graft Insertion into Pre-made Incisions

19. Stick and place
• sticker creates the site, and placer inserts the graft
• less bleeding
• no missed sites or piggy backing
• more difficult to control the distribution of the grafts

20. Implanter
• the incision is made and graft is placed simultaneously
• less bleeding
• no missed sites or piggy backing
• no time gap in which the recipient site is left empty and capable of
bleeding
• less trauma
• faster than traditional S&P

21. Implanter

22. Implanter

23. Trauma to hair bulb kinky hair growth
Desiccation poor growth or no growth
Incorrect position poor growth or no growth
pitting
compression
inclusion cyst
ingrown hair
grafty look
unnatural cowlick
Careless handling difficult insertion
irregular growth
popping
ingrown hair
unnatural result